Privacy Act of 1974; System of Records, 51568-51570 [E9-24130]

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51568
Federal Register / Vol. 74, No. 193 / Wednesday, October 7, 2009 / Notices
amendment or denied. Records are
destroyed by burn bag.
address, home mailing address of
individuals submitting material for
security review, and title/subject of
submitted document.
SYSTEM MANAGER(S) AND ADDRESS:
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
DoD Directive 5230.9, Clearance of
DoD Information for Public Release;
DoD Instruction 5230.29, Security and
Policy Review of DoD Information for
Public Release; 5 U.S.C. 301,
Departmental Regulations.
PURPOSE(S):
To manage the security review
process for documents or materials
before they are released outside of the
DoD. The documents and materials of
completed security reviews are
maintained for historical reference to
ensure subsequent reviews, which may
be similar in content, are handled
consistently.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
In addition to those disclosures
generally permitted under 5 U.S.C.
552a(b) of the Privacy Act of 1974, these
records may specifically be disclosed
outside the DoD as a routine use
pursuant to 5 U.S.C. 552a(b)(3) as
follows:
The DoD ‘Blanket Routine Uses’ set
forth at the beginning of OSD’s
compilation of systems of records
notices apply to this system.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
Paper records and electronic storage
media.
RETRIEVEABILITY:
By name and title/subject of
submitted document.
Individuals seeking to determine
whether information about themselves
is contained in this system of records
should address written inquiries to
Office of Security Review, Executive
Services Directorate, Washington
Headquarters Services, 1155 Defense
Pentagon, Washington, DC 20301–1155.
Written requests should include the
individual’s name and title/subject of
document submitted.
RECORD ACCESS PROCEDURES:
Individuals seeking access to
information about themselves contained
in this system of records should address
written inquiries to Office of the
Secretary of Defense/Joint Staff,
Freedom of Information Requester
Service Center, Office of Freedom of
Information, Executive Services
Directorate, Washington Headquarters
Service, 1155 Defense Pentagon,
Washington, DC 20301–1155.
Written requests should include the
name and number of this system of
records notice, the individual’s name,
title/subject of submitted document, and
be signed.
The OSD rules for accessing records,
for contesting contents and appealing
initial agency determinations are
published in OSD Administrative
Instruction 81; 32 CFR part 311; or may
be obtained from the system manager.
Paper records are accessed only by
officials with need to know and
appropriate security clearance in
accordance with assigned duties.
Electronic records require Common
Access Card to access and are further
password protected with access limited
to those individuals who have a needto-know.
Records are destroyed 2 years after
clearance without amendment;
destroyed 6 years after record was
cleared with amendment, or denied
clearance. Security review appeal files
which are cleared are destroyed 2 years
after clearance; and destroyed 6 years
after record was cleared with
15:25 Oct 06, 2009
Jkt 220001
ADDRESSES: Send comments to the
Office of the Secretary of Defense,
Privacy Act Coordinator, Records
Management Section, Washington
Headquarters Services, 1155 Defense
Pentagon, Washington, DC 20301–1155.
FOR FURTHER INFORMATION CONTACT: Ms.
Cindy Allard at (703) 588–2386.
SUPPLEMENTARY INFORMATION: The Office
of the Secretary of Defense systems of
records notices subject to the Privacy
Act of 1974, (5 U.S.C. 552a), as
amended, have been published in the
Federal Register and are available from
the address above.
The proposed system report, as
required by 5 U.S.C. 552a(r), of the
Privacy Act of 1974, as amended, was
submitted on September 25, 2009, to the
House Committee on Oversight and
Government Reform, the Senate
Committee on Homeland Security and
Governmental Affairs, and the Office of
Management and Budget (OMB)
pursuant to paragraph 4c of Appendix I
to OMB Circular No. A–130, ‘‘Federal
Agency Responsibilities for Maintaining
Records About Individuals,’’ dated
February 8, 1996 (February 20, 1996, 61
FR 6427).
Dated: September 25, 2009.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
SYSTEM NAME:
From the individual.
EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.
Medical/Dental Care and Claims
Inquiry Files (March 29, 2006, 71 FR
15707).
[FR Doc. E9–24129 Filed 10–6–09; 8:45 am]
CHANGES:
BILLING CODE 5001–06–P
*
[Docket ID DOD–2009–OS–0142]
Privacy Act of 1974; System of
Records
Office of the Secretary, DoD.
Notice to alter a system of
AGENCY:
ACTION:
records.
PO 00000
Frm 00019
Fmt 4703
Sfmt 4703
*
*
*
*
CATEGORIES OF RECORDS IN THE SYSTEM:
DEPARTMENT OF DEFENSE
Office of the Secretary
RETENTION AND DISPOSAL:
DATES: This proposed action will be
effective without further notice on
November 6, 2009 unless comments are
received which result in a contrary
determination.
DTMA 02
RECORD SOURCE CATEGORIES:
SAFEGUARDS:
erowe on DSK5CLS3C1PROD with NOTICES
NOTIFICATION PROCEDURE:
CONTESTING RECORD PROCEDURES:
STORAGE:
VerDate Nov<24>2008
Chief, Office of Security Review,
Executive Services Directorate,
Washington Headquarters Services,
1155 Defense Pentagon, Washington, DC
20301–1155.
SUMMARY: The Office of the Secretary of
Defense is proposing to alter a system of
records notice in its existing inventory
of record systems subject to the Privacy
Act of 1974, (5 U.S.C. 552a), as
amended.
Delete entry and replace with
‘‘Inquiries received from private
individuals for information on
TRICARE/CHAMPUS and CHAMPVA,
and replies thereto; congressional
inquiries on behalf of constituents and
replies thereto; and files notifying
personnel of eligibility or termination of
benefits. Information may include:
Name; Social Security Number (SSN);
date of birth; case number; dates of
E:\FR\FM\07OCN1.SGM
07OCN1
Federal Register / Vol. 74, No. 193 / Wednesday, October 7, 2009 / Notices
treatment; medical diagnosis; Defense
Enrollment Eligibility Reporting System
(DEERS) data; address; telephone
number; marital status; adoption
information; and sponsor name.’’
AUTHORITIES FOR MAINTENANCE OF THE SYSTEM:
Delete entry and replace with ‘‘41
CFR 101–11.000, Federal Records and
Standard and Optional Forms; 10 U.S.C.
55, Medical and Dental Care; 38 U.S.C.
1781, Medical Care for survivors and
dependents of certain veterans, and E.O.
9397 (SSN), as amended.’’
*
*
*
*
*
STORAGE:
Delete entry and replace with ‘‘Paper
records and electronic storage media.’’
*
*
*
*
*
RETENTION AND DISPOSAL:
Delete entry and replace with ‘‘Paper
records are retained in active files until
end of calendar year in which they are
received, then closed out and held 1
additional year. Then transferred to the
Federal Records Center (FRC), the FRC
shall destroy after an additional 5 years.
Paper copy records that have been
converted to electronic, microfilm,
imaging or optical formats, the paper
copy is destroyed after verification of
data, and the electronic, microfilm,
imaging, or optical format are kept by
the contractor for 6 years after the claim
is processed to completion, and then
destroyed by cross shredding,
macerating, degaussing or by a
commercially bonded or insured vendor
who must provide a certificate of
destruction. The destruction of the
records must be witnessed. Destruction
of the records is dependent on any
records preservation orders that may be
in effect.’’
SYSTEM MANAGER(S) AND ADDRESS:
Delete entry and replace with
‘‘TRICARE Management Activity,
Department of Defense,
Communications and Customer Service
Division, Skyline 5, 5111 Leesburg Pike,
Falls Church, VA 22041–3206.’’
erowe on DSK5CLS3C1PROD with NOTICES
NOTIFICATION PROCEDURE:
Delete entry and replace with
‘‘Individuals seeking to determine
whether information about themselves
is contained in this system should
address written inquiries to the
TRICARE Management Activity,
Department of Defense, ATTN:
Communications and Customer Service
Division, Skyline 5, 5111 Leesburg Pike,
Falls Church, VA 22041–3206; or
TRICARE Management Activity Privacy
Office, Skyline 5, Suite 810, 5111
Leesburg Pike, Falls Church, VA 22041–
3201.
VerDate Nov<24>2008
15:25 Oct 06, 2009
Jkt 220001
Written requests should include
name, Social Security Number (SSN)
and dates treatment received.’’
RECORD ACCESS PROCEDURES:
Delete entry and replace with
‘‘Individuals seeking access to
information about themselves contained
in this system should address written
inquiries to the OSD/JS FOIA Requester
Service Center, 1155 Defense Pentagon,
Washington, DC 20301–1155.
Written requests should include
name, Social Security Number (SSN)
and dates treatment received.’’
*
*
*
*
*
DTMA 02
SYSTEM NAME:
Medical/Dental Care and Claims
Inquiry Files.
SYSTEM LOCATION:
TRICARE Management Activity,
Department of Defense, 16401 East
Centretech Parkway, Aurora, CO 80011–
9066, and contractors under contract to
TRICARE. A listing of TRICARE
contractors maintaining these records is
available from the system manager.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
All individuals who seek information
concerning health care (medical and
dental) under TRICARE/CHAMPUS and
CHAMPVA.
CATEGORIES OF RECORDS IN THE SYSTEM:
Inquiries received from private
individuals for information on
TRICARE/CHAMPUS and CHAMPVA,
and replies thereto; congressional
inquiries on behalf of constituents and
replies thereto; and files notifying
personnel of eligibility or termination of
benefits. Information may include:
Name; Social Security Number (SSN);
date of birth; case number; dates of
treatment; medical diagnosis; Defense
Enrollment Eligibility Reporting System
(DEERS) data; address; telephone
number; marital status; adoption
information; and sponsor name.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
41 CFR 101–11.000, Federal Records
and Standard and Optional Forms; 10
U.S.C. 55, Medical and Dental Care; 38
U.S.C. 1781, Medical Care for survivors
and dependents of certain veterans and
E.O. 9397 (SSN), as amended.
PURPOSE(S):
To maintain and control records
pertaining to requests for information
concerning an individual’s TRICARE/
CHAMPUS eligibility status, the
benefits provided under programs of
PO 00000
Frm 00020
Fmt 4703
Sfmt 4703
51569
TRICARE/CHAMPUS and CHAMPVA
and the processing of individual
TRICARE/CHAMPUS and CHAMPVA
claims.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
In addition to those disclosures
generally permitted under 5 U.S.C. 552a
(b) of the Privacy Act of 1974, these
records contained therein may
specifically be disclosed outside the
DoD as a routine use pursuant to 5
U.S.C. 552a (b) (3) as follows:
To the Department of Health and
Human Services and/or the Department
of Veterans Affairs consistent with their
statutory administrative responsibilities
under TRICARE/CHAMPUS and
CHAMPVA pursuant to chapter 55, 10
U.S.C. and section 613, chapter 17, 38
U.S.C.
To Federal, state, local, or foreign
governmental agencies, and to private
business entities, including individual
providers of care (participating and nonparticipating), on matters relating to
eligibility, claims pricing and payment,
fraud, program abuse, utilization
review, quality assurance, peer review,
program integrity, third-party liability,
coordination of benefits, and civil or
criminal litigation related to the
operation of TRICARE/CHAMPUS.
To third-party contacts in situations
where the party to be contacted has, or
is expected to have, information
necessary to establish the validity of
evidence or to verify the accuracy of
information presented by the individual
concerning his or her entitlement, the
amount of benefit payments, any review
of suspected abuse or fraud, or any
concern for program integrity or quality
appraisal.
The DoD ’Blanket Routine Uses’ set
forth at the beginning of OSD’s
compilation of systems of records
notices apply to this system.
Note: This system of records contains
individually identifiable health information.
The DoD Health Information Privacy
Regulation (DoD 6025.18–R) issued pursuant
to the Health Insurance Portability and
Accountability Act of 1996, applies to most
such health information. DoD 6025.18–R may
place additional procedural requirements on
the uses and disclosures of such information
beyond those found in the Privacy Act of
1974 or mentioned in this system of records
notice.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Paper records and electronic storage
media.
E:\FR\FM\07OCN1.SGM
07OCN1
51570
Federal Register / Vol. 74, No. 193 / Wednesday, October 7, 2009 / Notices
RETRIEVABILITY:
Information is retrieved by case
number, sponsor name and/or Social
Security Number (SSN) and inquirer
name.
SAFEGUARDS:
Records are maintained in areas
accessible only to authorized personnel
who are properly screened, cleared, and
trained. Automated segments are
accessible only by authorized persons
possessing user identification codes.
Security systems and/or security guards
protect buildings where records are
maintained.
RETENTION AND DISPOSAL:
Paper records are retained in active
files until end of calendar year in which
they are received, then closed out and
held 1 additional year. Then transferred
to the Federal Records Center (FRC), the
FRC shall destroy after an additional 5
years. Paper copy records that have been
converted to electronic, microfilm,
imaging or optical formats, the paper
copy is destroyed after verification of
data, and the electronic, microfilm,
imaging, or optical format are kept by
the contractor for 6 years after the claim
is processed to completion, and then
destroyed by cross shredding,
macerating, degaussing or by a
commercially bonded or insure vendor
who must provide a certificate of
destruction. The destruction of the
records must be witnessed. Destruction
of the records is dependent on any
records preservation orders that may be
in effect.
SYSTEM MANAGER(S) AND ADDRESS:
TRICARE Management Activity,
Department of Defense,
Communications and Customer Service
Division, Skyline 5, 5111 Leesburg Pike,
Falls Church, VA 22041–3206.
erowe on DSK5CLS3C1PROD with NOTICES
Individuals seeking to determine
whether information about themselves
is contained in this system should
address written inquiries to the
TRICARE Management Activity,
Department of Defense, ATTN:
Communications and Customer Service
Division, Skyline 5, 5111 Leesburg Pike,
Falls Church, VA 22041–3206; or
TRICARE Management Activity Privacy
Office, Skyline 5, Suite 810, 5111
Leesburg Pike, Falls Church, VA 22041–
3201.
Written requests should include
name, Social Security Number (SSN)
and dates treatment received.
RECORD ACCESS PROCEDURES:
Individuals seeking access to
information about themselves contained
15:25 Oct 06, 2009
CONTESTING RECORD PROCEDURES:
The OSD rules for accessing records,
for contesting contents, and appealing
initial agency determinations are
published in OSD Administrative
Instruction 81; 32 CFR part 311; or may
be obtained from the system manager.
Jkt 220001
FOR FURTHER INFORMATION CONTACT: Ms.
Phyllis Hughes, Director, Human
Capital Advisory Services,
Administration and Management, DoD
OIG, 400 Army Navy Drive, Arlington,
VA 22202, (703) 602–4516.
SUPPLEMENTARY INFORMATION: In
accordance with 5 U.S.C. 4314(c)(4), the
following executives are appointed to
the DoD OIG, PRB:
Charles
Coe,
Jr.
Assistant Inspector General for Information Technology Audits and
Computer Crime Investigations,
Department of Education.
Assistant Inspector General for Investigations, Department of Agriculture.
Assistant Inspector General for
Audit, Department of Treasury.
Karen
Ellis.
Marla
Freedman.
Lisa
Martin.
General Counsel, United States
Postal Service, Office of Inspector General.
Linda
Assistant Inspector General for
Snider.
Resource Management, Department of Energy.
Dated: September 28, 2009.
Patricia L. Toppings,
OSD Federal Register Liaison Officer,
Department of Defense.
[FR Doc. E9–24128 Filed 10–6–09; 8:45 am]
RECORD SOURCE CATEGORIES:
BILLING CODE 5001–06–P
Contractors, congressional offices,
Health Benefits Advisors, all branches
of the Uniformed Service, congressional
offices, providers of care, consultants,
and individuals.
DEPARTMENT OF DEFENSE
EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.
Department of Air Force
[Docket No. USAF–2009–0058]
[FR Doc. E9–24130 Filed 10–6–09; 8:45 am]
Privacy Act of 1974; System of
Records
BILLING CODE 5001–06–P
AGENCY:
ACTION:
Senior Executive Service Performance
Review Board
AGENCY:
Office of Inspector General,
DoD.
ACTION:
Notice.
SUMMARY: This notice announces the
appointment of the members of the
Senior Executive Service (SES)
Performance Review Board (PRB) for the
Department of Defense Office of
Inspector General (DoD OIG), as
required by 5 U.S.C. 4314(c)(4). The
PRB provides fair and impartial review
of SES performance appraisals and
makes recommendations regarding
performance ratings and performance
awards to the Inspector General.
DATES: Effective October 1, 2009.
PO 00000
Frm 00021
Fmt 4703
Sfmt 4703
Department of Air Force, DoD.
Notice to amend a system of
records.
DEPARTMENT OF DEFENSE
Office of the Secretary
NOTIFICATION PROCEDURE:
VerDate Nov<24>2008
in this system should address written
inquiries to the OSD/JS FOIA Requester
Service Center, 1155 Defense Pentagon,
Washington, DC 20301–1155.
Written requests should include
name, Social Security Number (SSN)
and dates treatment received.
If it is determined that the release of
medical information to the requester
could have an adverse effect upon the
individual’s physical or mental health,
the requester should be prepared to
provide the name and address of a
physician who would be willing to
receive the medical record, and at the
physician’s discretion, inform the
individual covered by the system of the
contents of that record. In the event the
physician does not agree to convey the
information contained within the record
to the individual, TRICARE
Management Activity will take positive
measures to ensure the individual is
provided the requested information.
SUMMARY: The Department of Air Force
proposes to amend a system of records
in its inventory of record systems
subject to the Privacy Act of 1974 (5
U.S.C. 552a), as amended.
DATES: The changes will be effective on
November 6, 2009 unless comments are
received that would result in a contrary
determination.
ADDRESSES: Send comments to the Air
Force Privacy Act Officer, Office of
Warfighting Integration and Chief
Information Officer, SAF/XCPPI, 1800
Air Force Pentagon, Washington, DC
20330–1800.
FOR FURTHER INFORMATION CONTACT: Mr.
Ben Swilley at (703) 696–6172.
SUPPLEMENTARY INFORMATION: The
Department of the Air Force systems of
records notices subject to the Privacy
Act of 1974, (5 U.S.C. 552a), as
E:\FR\FM\07OCN1.SGM
07OCN1

Agencies

[Federal Register Volume 74, Number 193 (Wednesday, October 7, 2009)]
[Notices]
[Pages 51568-51570]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-24130]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID DOD-2009-OS-0142]
Privacy Act of 1974; System of Records
AGENCY: Office of the Secretary, DoD.
ACTION: Notice to alter a system of records.
-----------------------------------------------------------------------
SUMMARY: The Office of the Secretary of Defense is proposing to alter a
system of records notice in its existing inventory of record systems
subject to the Privacy Act of 1974, (5 U.S.C. 552a), as amended.
DATES: This proposed action will be effective without further notice on
November 6, 2009 unless comments are received which result in a
contrary determination.
ADDRESSES: Send comments to the Office of the Secretary of Defense,
Privacy Act Coordinator, Records Management Section, Washington
Headquarters Services, 1155 Defense Pentagon, Washington, DC 20301-
1155.
FOR FURTHER INFORMATION CONTACT: Ms. Cindy Allard at (703) 588-2386.
SUPPLEMENTARY INFORMATION: The Office of the Secretary of Defense
systems of records notices subject to the Privacy Act of 1974, (5
U.S.C. 552a), as amended, have been published in the Federal Register
and are available from the address above.
The proposed system report, as required by 5 U.S.C. 552a(r), of the
Privacy Act of 1974, as amended, was submitted on September 25, 2009,
to the House Committee on Oversight and Government Reform, the Senate
Committee on Homeland Security and Governmental Affairs, and the Office
of Management and Budget (OMB) pursuant to paragraph 4c of Appendix I
to OMB Circular No. A-130, ``Federal Agency Responsibilities for
Maintaining Records About Individuals,'' dated February 8, 1996
(February 20, 1996, 61 FR 6427).
Dated: September 25, 2009.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
DTMA 02
System name:
Medical/Dental Care and Claims Inquiry Files (March 29, 2006, 71 FR
15707).
Changes:
* * * * *
Categories of records in the system:
Delete entry and replace with ``Inquiries received from private
individuals for information on TRICARE/CHAMPUS and CHAMPVA, and replies
thereto; congressional inquiries on behalf of constituents and replies
thereto; and files notifying personnel of eligibility or termination of
benefits. Information may include: Name; Social Security Number (SSN);
date of birth; case number; dates of
[[Page 51569]]
treatment; medical diagnosis; Defense Enrollment Eligibility Reporting
System (DEERS) data; address; telephone number; marital status;
adoption information; and sponsor name.''
Authorities for maintenance of the system:
Delete entry and replace with ``41 CFR 101-11.000, Federal Records
and Standard and Optional Forms; 10 U.S.C. 55, Medical and Dental Care;
38 U.S.C. 1781, Medical Care for survivors and dependents of certain
veterans, and E.O. 9397 (SSN), as amended.''
* * * * *
Storage:
Delete entry and replace with ``Paper records and electronic
storage media.''
* * * * *
Retention and disposal:
Delete entry and replace with ``Paper records are retained in
active files until end of calendar year in which they are received,
then closed out and held 1 additional year. Then transferred to the
Federal Records Center (FRC), the FRC shall destroy after an additional
5 years. Paper copy records that have been converted to electronic,
microfilm, imaging or optical formats, the paper copy is destroyed
after verification of data, and the electronic, microfilm, imaging, or
optical format are kept by the contractor for 6 years after the claim
is processed to completion, and then destroyed by cross shredding,
macerating, degaussing or by a commercially bonded or insured vendor
who must provide a certificate of destruction. The destruction of the
records must be witnessed. Destruction of the records is dependent on
any records preservation orders that may be in effect.''
System manager(s) and address:
Delete entry and replace with ``TRICARE Management Activity,
Department of Defense, Communications and Customer Service Division,
Skyline 5, 5111 Leesburg Pike, Falls Church, VA 22041-3206.''
Notification procedure:
Delete entry and replace with ``Individuals seeking to determine
whether information about themselves is contained in this system should
address written inquiries to the TRICARE Management Activity,
Department of Defense, ATTN: Communications and Customer Service
Division, Skyline 5, 5111 Leesburg Pike, Falls Church, VA 22041-3206;
or TRICARE Management Activity Privacy Office, Skyline 5, Suite 810,
5111 Leesburg Pike, Falls Church, VA 22041-3201.
Written requests should include name, Social Security Number (SSN)
and dates treatment received.''
Record access procedures:
Delete entry and replace with ``Individuals seeking access to
information about themselves contained in this system should address
written inquiries to the OSD/JS FOIA Requester Service Center, 1155
Defense Pentagon, Washington, DC 20301-1155.
Written requests should include name, Social Security Number (SSN)
and dates treatment received.''
* * * * *
DTMA 02
System name:
Medical/Dental Care and Claims Inquiry Files.
System location:
TRICARE Management Activity, Department of Defense, 16401 East
Centretech Parkway, Aurora, CO 80011-9066, and contractors under
contract to TRICARE. A listing of TRICARE contractors maintaining these
records is available from the system manager.
Categories of individuals covered by the system:
All individuals who seek information concerning health care
(medical and dental) under TRICARE/CHAMPUS and CHAMPVA.
Categories of records in the system:
Inquiries received from private individuals for information on
TRICARE/CHAMPUS and CHAMPVA, and replies thereto; congressional
inquiries on behalf of constituents and replies thereto; and files
notifying personnel of eligibility or termination of benefits.
Information may include: Name; Social Security Number (SSN); date of
birth; case number; dates of treatment; medical diagnosis; Defense
Enrollment Eligibility Reporting System (DEERS) data; address;
telephone number; marital status; adoption information; and sponsor
name.
Authority for maintenance of the system:
41 CFR 101-11.000, Federal Records and Standard and Optional Forms;
10 U.S.C. 55, Medical and Dental Care; 38 U.S.C. 1781, Medical Care for
survivors and dependents of certain veterans and E.O. 9397 (SSN), as
amended.
Purpose(s):
To maintain and control records pertaining to requests for
information concerning an individual's TRICARE/CHAMPUS eligibility
status, the benefits provided under programs of TRICARE/CHAMPUS and
CHAMPVA and the processing of individual TRICARE/CHAMPUS and CHAMPVA
claims.
Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
In addition to those disclosures generally permitted under 5 U.S.C.
552a (b) of the Privacy Act of 1974, these records contained therein
may specifically be disclosed outside the DoD as a routine use pursuant
to 5 U.S.C. 552a (b) (3) as follows:
To the Department of Health and Human Services and/or the
Department of Veterans Affairs consistent with their statutory
administrative responsibilities under TRICARE/CHAMPUS and CHAMPVA
pursuant to chapter 55, 10 U.S.C. and section 613, chapter 17, 38
U.S.C.
To Federal, state, local, or foreign governmental agencies, and to
private business entities, including individual providers of care
(participating and non-participating), on matters relating to
eligibility, claims pricing and payment, fraud, program abuse,
utilization review, quality assurance, peer review, program integrity,
third-party liability, coordination of benefits, and civil or criminal
litigation related to the operation of TRICARE/CHAMPUS.
To third-party contacts in situations where the party to be
contacted has, or is expected to have, information necessary to
establish the validity of evidence or to verify the accuracy of
information presented by the individual concerning his or her
entitlement, the amount of benefit payments, any review of suspected
abuse or fraud, or any concern for program integrity or quality
appraisal.
The DoD 'Blanket Routine Uses' set forth at the beginning of OSD's
compilation of systems of records notices apply to this system.
Note: This system of records contains individually identifiable
health information. The DoD Health Information Privacy Regulation
(DoD 6025.18-R) issued pursuant to the Health Insurance Portability
and Accountability Act of 1996, applies to most such health
information. DoD 6025.18-R may place additional procedural
requirements on the uses and disclosures of such information beyond
those found in the Privacy Act of 1974 or mentioned in this system
of records notice.
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Paper records and electronic storage media.
[[Page 51570]]
Retrievability:
Information is retrieved by case number, sponsor name and/or Social
Security Number (SSN) and inquirer name.
Safeguards:
Records are maintained in areas accessible only to authorized
personnel who are properly screened, cleared, and trained. Automated
segments are accessible only by authorized persons possessing user
identification codes. Security systems and/or security guards protect
buildings where records are maintained.
Retention and disposal:
Paper records are retained in active files until end of calendar
year in which they are received, then closed out and held 1 additional
year. Then transferred to the Federal Records Center (FRC), the FRC
shall destroy after an additional 5 years. Paper copy records that have
been converted to electronic, microfilm, imaging or optical formats,
the paper copy is destroyed after verification of data, and the
electronic, microfilm, imaging, or optical format are kept by the
contractor for 6 years after the claim is processed to completion, and
then destroyed by cross shredding, macerating, degaussing or by a
commercially bonded or insure vendor who must provide a certificate of
destruction. The destruction of the records must be witnessed.
Destruction of the records is dependent on any records preservation
orders that may be in effect.
System manager(s) and address:
TRICARE Management Activity, Department of Defense, Communications
and Customer Service Division, Skyline 5, 5111 Leesburg Pike, Falls
Church, VA 22041-3206.
Notification procedure:
Individuals seeking to determine whether information about
themselves is contained in this system should address written inquiries
to the TRICARE Management Activity, Department of Defense, ATTN:
Communications and Customer Service Division, Skyline 5, 5111 Leesburg
Pike, Falls Church, VA 22041-3206; or TRICARE Management Activity
Privacy Office, Skyline 5, Suite 810, 5111 Leesburg Pike, Falls Church,
VA 22041-3201.
Written requests should include name, Social Security Number (SSN)
and dates treatment received.
Record access procedures:
Individuals seeking access to information about themselves
contained in this system should address written inquiries to the OSD/JS
FOIA Requester Service Center, 1155 Defense Pentagon, Washington, DC
20301-1155.
Written requests should include name, Social Security Number (SSN)
and dates treatment received.
If it is determined that the release of medical information to the
requester could have an adverse effect upon the individual's physical
or mental health, the requester should be prepared to provide the name
and address of a physician who would be willing to receive the medical
record, and at the physician's discretion, inform the individual
covered by the system of the contents of that record. In the event the
physician does not agree to convey the information contained within the
record to the individual, TRICARE Management Activity will take
positive measures to ensure the individual is provided the requested
information.
Contesting record procedures:
The OSD rules for accessing records, for contesting contents, and
appealing initial agency determinations are published in OSD
Administrative Instruction 81; 32 CFR part 311; or may be obtained from
the system manager.
Record source categories:
Contractors, congressional offices, Health Benefits Advisors, all
branches of the Uniformed Service, congressional offices, providers of
care, consultants, and individuals.
Exemptions claimed for the system:
None.
[FR Doc. E9-24130 Filed 10-6-09; 8:45 am]
BILLING CODE 5001-06-P